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All Journal Microbiology Indonesia Indonesian Journal of Tropical and Infectious Disease The Indonesian Biomedical Journal Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Respirasi (JR) Indonesian Journal of Kidney and Hypertension Biomolecular and Health Science Journal Majalah Biomorfologi (Biomorphology Journal) Narra J Personifikasi: Jurnal Ilmu Psikologi Journal of Indonesia Vascular Access Folia Medica Indonesiana
MOCHAMMAD THAHA
Department Of Internal Medicine, Faculty Of Medicine, Universitas Airlangga, Surabaya
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Efficacy of angiotensin receptor neprilysin inhibitor in hypertension management: A systematic review and meta-analysis of clinical trials Ramadhan, Roy N.; Rampengan, Derren DCH.; Puling, Imke MDR.; Willyanto, Sebastian E.; Tjandra, Kevin C.; Thaha, Mochammad; Multazam, Chaq ECZ.; Suryantoro, Satriyo
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1247

Abstract

Dysregulation of renin-angiotensin-aldosterone system (RAAS) often leads to hypertension and severe cardiorenal complications. Although RAAS-targeted therapies have proven effective, it remains yet optimal in reducing cardiovascular events. The aim of this study was to evaluate the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI) compared to control in patients with hypertension. The primary outcomes were systolic and diastolic blood pressure (BP) control, along with the incidence of adverse events. A systematic review and meta-analysis was conducted according following PRISMA guidelines. A comprehensive literature search was performed across five databases: PubMed, ScienceDirect, EBSCO, Cochrane, and ProQuest, with studies identified up until 3 October 2024. The study included nine clinical trials that met the predefined eligibility criteria: (1) randomized clinical trials; (2) adult patients diagnosed with hypertension; and (3) comparison of ARNI versus control, reporting either BP control or adverse events. Quality appraisal using RoB 2.0 revealed that eight studies had a low risk of bias, and one had a high risk of bias. The pooled analysis demonstrated that ARNI is significantly more efficacious in achieving targeted systolic BP as compared to the control group (OR: 1.80; 95%CI: 1.41-2.30; p<0.001; I²=0%), and there was no statistical difference for the efficacy on diastolic BP compared to control (OR: 0.92; 95%CI: 0.75–1.13; p=0.45; I²=75%). The incidence of adverse events was not associated with ARNI (OR: 1.07; 95%CI: 0.90–1.27; p=0.46; I²=72%). In conclusion, ARNI demonstrated a favorable outcome only in systolic BP, but in diastolic BP which could be associated with inadequate duration of observation. Further studies are warranted to assess BP-lowering effect and safety profile of ARNI in a longer observation time.
Co-Authors Aditia Wardana Ahadini, Putri Aliya Alisia Y Putri, Alisia Y Arifa Mustika Artaria Tjempakasari, Artaria Berliana Hamidah Budi Susetyo Pikir Budiono Budiono Cahyo Wibisono Nugroho chandra irwanadi David Setyo Budi Dinda Dwi Purwati Djoko Santoso Eka Arum Cahyaning Putri Haerani Rasyid Haerani Rasyid HAK HOTTA Hakim, Arief Rakhman Hendri Susilo I Gde Raka Widiana Ika Nindya Kadariswantiningsih Ira Paramastri Juniastuti Juniastuti Kwartarini Wahyu Yuniarti Laurentius Andre Lukman Hakim M. Amin M. Noor Rochman Hadjam MARIA INGE LUSIDA Maulana Antiyan Empitu Maulana Muhtadin Suryansyah Maulana Muhtadin Suryansyah Maulana Muhtadin Suryansyah MOCHAMAD AMIN Mochamad Yusuf Alsagaff Mochammad Amin Mochammad Yusuf Alsagaff Mochammad Yusuf, Mochammad Moh. Yogiantoro, Moh. Mohammad Yusuf Alsagaff Mohammad Yusuf Alsagaff Multazam, Chaq ECZ. Mutiara Rizki Haryati Nunuk Mardiana, Nunuk Nur Istiqomah Nurina Hasanatuludhhiyah Nurwidda, Arvi Dian Prasetia Pakpahan, Cennikon Pranawa Pranawa Priyo Budi Purwono Puling, Imke MDR. Putri Aliya Ahadini Ramadhan, Roy N. Rampengan, Derren DCH. Retno Handajani Rieza Rizqi Alda Rieza Rizqi Alda Rosyid, Alfian Nur Saphira, Diva Sharifa Audi Salsabila Soebroto, Heroe SOETJIPTO . Suryantoro, Satriyo Suryantoro, Satriyo Dwi TAKAKO UTSUMI Tjandra, Kevin C. Tri Asih Imroati Wenny P Nilamsari, Wenny P WENNY PUTRI NILAMSARI, WENNY PUTRI Widipriyatama, Gabriel Rio Widodo Widodo Widodo Widodo Willyanto, Sebastian E. Wungu, Citrawati Dyah Kencono Yasuhiko Tomino, Yasuhiko Yetti Hernaningsih YOSHIHIKO YANO YOSHITAKE HAYASHI Yusuke Suzuki Yusuke Suzuki Yusuke Suzuki Zaky El Hakim Zaky El Hakim Zaky Firmawan El-Hakim